The findings were published in JAMA Dermatology by Eudora Lee, BS, Harvard Medical School, Boston, Massachusetts, and colleagues.
Enfortumab vedotin is an antibody-drug conjugate approved for the treatment of locally advanced or metastatic urothelial cancer. Skin-related adverse events are common during EV therapy, but it has remained uncertain whether these reactions independently predict improved outcomes or are influenced by concurrent immune checkpoint inhibitor (ICI) treatment. To clarify this, researchers evaluated the relationship between EV-induced cutaneous adverse events and survival, as well as the timing and clinical characteristics of these skin reactions.
The multi-institutional retrospective cohort study evaluated 449 patients with locally advanced or metastatic urothelial cancer treated with enfortumab vedotin (EV) between 2020 and 2025. Researchers used manual chart review and a likelihood scoring system to attribute cutaneous adverse events to EV or other causes. They assessed progression-free and overall survival using Kaplan-Meier and multivariable Cox regression analyses. The mean participant age was 71.9 years; 27.2% were women and 72.8% were men.
Key findings from the study include:
- 206 patients (45.9%) developed cutaneous adverse events during EV treatment, with 127 cases (61.7%) attributed directly to enfortumab vedotin.
- The most frequently observed EV-related skin toxicities were pruritus, unspecified or desquamating dermatitis, and morbilliform dermatitis.
- Patients who developed EV-induced cutaneous adverse events experienced significantly longer progression-free survival and overall survival than those without these reactions.
- At the primary 30-day landmark analysis, EV-induced skin toxicities were associated with a 40% lower risk of disease progression (HR, 0.60) and a 54% lower risk of death (HR, 0.46).
- Early-onset EV-induced cutaneous adverse events remained associated with improved survival across all landmark analyses, while high-grade skin toxicities were not linked to poorer survival outcomes.
The researchers concluded that EV-induced cutaneous adverse events were independently associated with improved progression-free and overall survival, even after adjusting for immortal time bias and immune checkpoint inhibitor exposure. They noted that accurately identifying these skin toxicities may help optimize oncologic and dermatologic management while serving as a potential prognostic marker during EV treatment.
Reference:
Lee E, Karagenova R, Lu C, et al. Enfortumab Vedotin−Induced Cutaneous Toxic Effects and Survival in Urothelial Carcinoma. JAMA Dermatol. Published online July 29, 2026. doi:10.1001/jamadermatol.2026.2543
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.